| Christine Dalton Mbr | |
|
83 Athens St Jefferson GA 30549-1401 | |
| (706) 387-0573 | |
| (706) 387-0573 |
| Full Name | Christine Dalton Mbr |
|---|---|
| Speciality | Social Worker |
| Location | 83 Athens St, Jefferson, Georgia |
| Authorized Official Name and Position | Christine B Dalton (OWNER) |
| Authorized Official Contact | 7063870573 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Christine Dalton Mbr 83 Athens St Jefferson GA 30549-1401 Ph: (706) 387-0573 | Christine Dalton Mbr 83 Athens St Jefferson GA 30549-1401 Ph: (706) 387-0573 |
| NPI Number | 1457769739 |
|---|---|
| Provider Enumeration Date | 07/30/2014 |
| Last Update Date | 07/30/2014 |
| Medicare PECOS PAC ID | 7911128061 |
|---|---|
| Medicare Enrollment ID | O20141015000752 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457769739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW004024 (Georgia) | Primary |
| Provider Name | Christine B Dalton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043468747 PECOS PAC ID: 7416016878 Enrollment ID: I20081030000534 |
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